Surgical neovagina reconstruction in mullerian agenesis

Abstract

Introduction: Functional neovagina reconstruction is a challenge faced by plastic surgeons. Different patients with varied etiologies present for vaginal reconstruction as in congenital vaginal aplasia, transsexuals and acquired defects following trauma, resection of carcinoma. Different techniques are available for vaginoplasty. Aim: To evaluate the anatomical and functional outcomes of vaginoplasty using two well established surgical techniques McIndoe with split skin graft and vaginplasty using Full thickness skin graft Material and Methods: This is a prospective study conducted at the department of plastic surgery,at a tertiary care centre at Bangalore ,India over a period of 2 years from January 2013 to January 2015. Results: A total 19 patients in age group of 15 to 34 years were operated during this period. 10 patients underwent vaginoplasty using Full thickness skin graft and 9 patients underwent vaginoplasty using Mcindoe technique with split skin graft. Average vaginal length at 2 months for FTSG was 9.0cm and average vaginal length at 6 months for FTSG 9.25 cm. Average vaginal length in SSG cases at 2 months was 8.7 cm and average vaginal length at 6 months 8.9 cm. There was no statistical difference in two groups regarding vaginal length (p>0.01). Mean FSFI score in patient treated with vaginoplasty with SSG was 26.6+1.8 and FSFI in patients treated with FTSG was 30.4+1.1 ( p<0.01). Conclusion: From this study we found that vaginoplasty with FTSG was associated with lesser donor site morbidity and patients were more satisfied with scar and also that the early vaginal length was better in FTSG and none of the patients treated with FTSG needed dilatation under anaesthesia. Operative time was marginally increased in FTSG cases as compared to the SSG patients.